Home | What's New | Our Services | Events & Activities | Career Opportunities | 4all.my | About Us | Contact Us
Encyclopaedia ->
Health Topics
Herbs
Nutrition
Drug
therapies
Tests
Symptoms
First letter
Body System
Dictionary The Digestive System

Gallstones

Synonyms :  Biliary Calculus; Cholelith; Cholelithiasis, AND Cholecystitis
Clinical features, Diagnosis, Management, Prognosis, Nutrition, Herbs,

Cholelithiasis (gallstone formation) is the commonest disorder of the biliary tree and it is unusual for the gallbladder to be diseased in the absence of gallstones. The condition affects about 20% of the population above 40 years of age. Gallstones are conveniently classified into cholesterol (made from cholesterol) or pigment stones (made from bilirubin with a variable degree of calcification). Cholesterol stones are the commonest type of gallstones encountered in developed countries (75%). 

Causes for gallstone formation:

       cholesterol gallstones occur when bile is supersaturated with cholesterol so it can crystallise, which can occur in different settings. Cholesterol is water insoluble and becomes water soluble by aggregation with bile salts and phospholipids such as lecithins, which are also found in bile. Risk factors for cholesterol stones are: increased age, female sex, increased parity, hormone replacement therapy, obesity, gastric surgery. The role of dietary cholesterol and hypercholesterolaemia is not certain, while high fat/low fibre diet and diabetes increase the risk. These stones are whitish/yellow, mainly round and greasy on the surface.

       pigment gallstones are formed when there is excess of unconjugated or conjugated bilirubin. Probably many factors can contribute to this situation such as infection in the biliary tree (through bacterial production of enzymes which can deconjugate bilirubin thus initiating precipitation and stone formation), haemolytic anaemia (increased production of bilirubin) and alcoholic cirrhosis (impaired conjugation of bilirubin). These stones are black, irregular, faceted or round, hard, almost like river pebbles, since they contain a substantial amount of calcium salts. 

Acute cholecystitis (inflammation of the gallbladder) is almost always associated with obstruction of the gallbladder neck or cystic duct by a gallstone. Reactive chemical inflammation of the gallbladder mucosa due to changes in chemical composition of bile follows eventually becoming bacterial in type (bacteria usually belong to normal gut flora). However, the exact pathogenesis of this transition is still not clear. Some patients have a chronic form of cholecystitis characterised by thick walled, fibrotic and contracted gallbladder, and presence of biliary sludge/stones in the lumen.

Clinical features:  < BACK TO TOP >

           Majority of gallstones are asymptomatic and remain so; only 20% sufferers develop clinical evidence of the disease.

           Gallstones eventually may present either as recurrent biliary pain caused by transient cystic duct obstruction or cholecystitis due to persistent cystic duct obstruction that hasn’t resolved.

           Biliary pain is located in the epigastrium or right upper abdominal quadrant, and radiates to the back to the interscapular region or the tip of the right scapula.

           The pain characteristically occurs after a fatty meal, progressively increasing to a plateau; it is sustained for about an hour and then subsiding gradually; overall duration of the pain is up to several hours.

           Nausea and vomiting often accompany the pain.

           Acute cholecystitis, together with more persistent pain (over 24 hours), usually presents with restlessness, pallor, sweating, nausea, vomiting, fever; fever is the most important distinguishing feature between uncomplicated biliary pain and cholecystitis.

           Tenderness in the right upper quadrant is usually noted, and jaundice can occur sometimes probably caused by oedema and obstruction of the common bile duct.

           A typical episode of acute cholecystitis improves in 2-3 days and disappears within 1 week; the most feared outcome is rupture of the gallbladder with spilling of purulent exudate (pus) into the abdominal cavity, leading to serious peritonitis.

           Differentiation between uncomplicated biliary pain and acute cholecystitis is often difficult on clinical ground.

Diagnosis:  < BACK TO TOP >

           Plain radiographs of the abdomen may show gallstones if they are radiopaque (cholesterol stones are not visible but bilirubin ones usually are due to their greater calcium component).

           Ultrasonography detects gallstones over 4mm in diameter and may show gallbladder thickening due to cholecystitis (oedema of the wall in acute and scarring in chronic cholecystitis).

           Cholecystography and cholescintigraphy show all types of gallstones as filling defects, but in cholecystitis the gallbladder usually can not be visualised due to cystic duct obstruction.

           Liver function tests are non-specific (variable increase in hepatic transaminases and alkaline phosphatase).

           Acute cholecystitis can be accompanied by leukocytosis and raised ESR.

Management  < BACK TO TOP >

           Asymptomatic gallstones found incidentally are not usually treated.

           Symptomatic gallstones are best treated surgically by means of cholecystectomy (removal of the gallbladder), preferably through a laparoscopic approach. Cholecystectomy relieves pain but for unknown reasons 50% of patients continue experiencing various digestive symptoms.

           Medical dissolution of cholesterol gallstones that are not calcified can be attempted using drugs based on bile acids such as ursodeoxycholic [Ursofalk] which increases the solubility of cholesterol. This is usually carried out in patients who decline surgery or when a surgery is associated with significant risk.

           Extracorporeal shock wave lithotripsy (ESWL) is a technique of gallstones fragmentation using shock waves (powerful vibrations) applied under water or on special table with a water-filled cushion. Fragments formed in this way can pass naturally through the biliary system or may dissolve and disappear spontaneously or on treatment.

           Management of acute cholecystitis consists of bed rest, relief of pain, antibiotics and maintenance of fluid balance. Surgical treatment is necessary (cholecystectomy by either laparotomy or laparoscopy) but it is usually done later (elective surgery).

           In some centres the surgery is attempted in acute episode of cholecystitis avoiding two hospitalisations and reducing costs, but such surgery can be more risky than the postponed one (e.g., rupture of acutely inflamed gallbladder with secondary peritonitis).

Prognosis  < BACK TO TOP >

    -

Nutrition < BACK TO TOP >

Nutrition that alleviate or prevent Gallstones :-
C

Herbs < BACK TO TOP >

Herbs that alleviate or prevent Gallstones :-
-

(source : -)

search this site the web

search engine by freefind

Disclaimer

Powered by visit montaine home page

Thank You visiting MONTAINE

Welcome To Montaine
action activity adventure aerobic aerobics after age air alternative medicine amateur areas arthritis athletes backpack backpacking backpacks bad bag barbeque basecamp based bay before beginners being benefit best bike biking blonde bmi body bodybuilder bodybuilding brand building BUY calculate calculated calculation calculator calculators calories camp camping camps cardiorespiratory cardiovascular center centers centre centres certification chat chi circuit climb climbing club clubs college competition competitor components conservation consumed consumption count courses day http://www.montaine.com.my/dictionary.htm definition download education environmental equipment erotica excercise exercise exercises exercising explore euro 2004 event famous fat female figure find fires fit fitness fittness for force franchise free gallery gay get getfit given glutes green greatest group groups guide guides gym gyms health height hikers hiking home homepage how human ideal idealweight in increasing index injures injuries instructions intermediates iron is kl knowing layout link locations loosing male man map maps mass massage masseur maximuscle me measure metabolism miss model models morning mount mountain mountaineering mountains mt multiple multistage muscle muscular music naked natural therapy national near new night noon nutrition occupational of online olympics or out outdoor outdoors page pages Pain park parks people per personal phisical photo photos physical picture pictures pilates porn program programs rafting rainbows reaction real recommendations recreation recreational rehab rehabilitation rentals requirements results rock rooms running school schools sclerosis scoliosis sex sexy should site sites source spinal sport sports stars state statistics studio studios student swedish swim swimsuit team techniques test testing tests the therapeutic therapist therapy time tips to top trail trails trainer trainers training trip trips ultimate university visitor watching water web weekend weekends weigh weight what white whitewater women womens workout world your yout
Tsunami online Donations and Information Tsumani online Donations and Infomation We are closed from Feb 9 to Feb 13, 2005 and will resume business on Feb 14, 2005

Donation Drive:The New Straits Times, Berita Harian, TV3, 8TV Malaysian Tsunami Disaster Fund The Star Earthquake/Tsunami Relief Fund Subang/USJ Disaster Fund theSun Tsunami Emergency Supplies Fund Asian Tsunami Disaster Fund - by the Foreign Ministry Yayasan Sultanah Bahiyah Buddhist Maha Vihara - 123 Jalan Berhala, Brickfields 50470 KL -Tel: 03 2274 1141, Fax: 03 2273 2570
¡¡

Montaine
Chinese New Year 2005
3 days post Chinese New Year detox programme
Local News & Info: Missing Persons E-mail Appeals Tsunami Penang Blog iPenang Screenshots The Star Bernama Project Petaling Street TV Smith's Tsunami InTech: Bloggers fill the void

12 August 20096December 2005


25 November 2004 International Day for the Elimination of Violence against WomenInternational Day of Innocent Children Victims of AggressionHuman Rights Day
International Youth Day

 sWorkshop探 访 各 类 癌 症 的 真 相10 June 2004 7:30am-8:30pmCall (603) 2713 9288 to reserve a seat
 
Charting Your Way to Success workshop Organised by JCI

Venue : Montaine Menara Weld Level 4 |

 Date  : 30th July 2004 Friday (6:30pm -8:00pm)

Organizer : JCI Kuala Lumpur |

 Contact    : Kelly 012-320 3350 & Ang 012-296 5138

 speaker Mr NgThian Watt the Principal Trainer from Napoleon Hill Associates MalaysiaDetails www.kljuniorchamber.org
Montaine's Health and Weight Management Programme
Call 012 201 8020 or 03 5636 6788 NOW
 

January, February, March, April, May, June, July, August, September, October, November, December
April Promotion
(Gift Voucher Available)
 - Spa Gateway - Beauty Gateway
Usual RM293 Now RM138

Queen of The Day  RM138 (2 hours)

          Full Body Exfoliation worth RM68 (30 minutes)

          Full Aromatherapy Massage worth RM128 (60 minutes)

          Full Body Detox Treatment worth RM128 (30 minutes)

   All For RM138Additional RM68 – Make Over (Evening Make Up)ecretary's Day Gift, Secretarie

Call 012 201 8020 or +603 5636 6788

 

Massage or Reflexology Package Buy 7 get 3 Free  (First 50 Customers or till 31 October 2004 Only, Hurry call 03 7710 5593 now!!)

Jobs vacancy
Customer Service Exec at Montaine centre

Salary RM1000 - RM4000 Female is preferable call KC at 012 201 8020

MONTAINE Centre of Health and Wellness
kl, jb, jp, au, Africa Antarctica Arctic Asia Caribbean Europe North America Oceania South America Afghanistan Kabul Albania Tirana Algeria Algiers Andorra Andorra la Vella Angola Luanda Antigua and Barbuda St. John's Argentina Buenos Aires Armenia Yerevan Australia Canberra Austria Vienna Azerbaijan Baku a port on the Caspian Sea Bahamas Nassau Bahrain Al-Manámah Bangladesh Dhaka Barbados Bridgetown Belarus Mensk (Minsk) Belgium Brussels Belize Belmopan Benin Porto-Novo Bhutan Thimphu Bolivia Sucre ; Administrative capital: La Paz Bosnia and Herzegovina Sarajevo(unofficial) Botswana Gaborone Brazil Brasília Brunei Darussalam Bandar Seri Begawan Bulgaria Sofia Burkina Faso Ouagadougou Burundi Bujumbura Cambodia Phnom Penh Cameroon Yaoundé Canada Ottawa Ontario Cape Verde Praia Central African Republic Bangui Chad N'Djamena Chile Santiago China Beijing Colombia Santafé de Bogotá Comoros Moroni Congo, Republic of Brazzaville Congo, Democratic Republic of the Kinshasa Costa Rica San José Côte d'Ivoire Yamoussoukro (official) Croatia Zagreb Cuba Havana Cyprus Lefkosia (Nicosia) (in government-controlled area) Czech Republic Prague Denmark Copenhagen Djibouti Djibouti Dominica Roseau Dominican Republic Santo Domingo East Timor Dili Ecuador Quito Egypt Cairo El Salvador San Salvador Equatorial Guinea Malabo Eritrea Asmara Estonia Tallinn Ethiopia Addis Ababa Fiji Suva (on Viti Levu) Finland Helsinki France Paris Gabon Libreville Gambia, The Banjul Georgia Tbilisi Germany Berlin (capital since Oct.) Ghana Accra Greece Athens Athens Grenada St. George's Guatemala Guatemala City Guinea Conakry Guinea-Bissau Bissau Guyana Georgetown Haiti Port-au-Prince Honduras Tegucigalpa Hungary Budapest Iceland Reykjavik India New Delhi Indonesia Jakarta Iran Teheran Iraq Baghdad Ireland Dublin Israel Jerusalem Italy Rome Jamaica Kingston Japan Tokyo Jordan Amman Kazakhstan Astana(formerly Aqmola; capital since ) Kenya Nairobi Kiribati Tarawa Korea, North Pyongyang Korea, South Seoul Kuwait Kuwait Kyrgyzstan Bishkek (formerly Frunze) Laos Vientiane Latvia Riga Lebanon Beirut Lesotho Maseru Liberia Monrovia Libya Tripoli Liechtenstein Vaduz Lithuania Vilnius Luxembourg Luxembourg Macedonia Skopje Madagascar Antananarivo Malawi Lilongwe Malaysia Kuala Lumpur Maldives Malé Mali Bamako Malta Valletta Marshall Islands Majuro Mauritania Nouakchott Mauritius Port Louis Mexico Mexico City Micronesia Palikir Moldova Chisinau Monaco Monaco Mongolia Ulaan Baatar Morocco Rabat Mozambique Maputo Myanmar Rangoon (Yangon) Namibia Windhoek Nauru Yaren Nepal Kathmandu The Netherlands Amsterdam (official) ; The Hague (administrative capital) New Zealand Wellington Nicaragua Managua Niger Niamey Nigeria Abuja Norway Oslo Oman Muscat Pakistan Islamabad Palau Koror Palestinian State (proposed) Undetermined Panama Panama City Papua New Guinea Port Moresby Paraguay Asunción Peru Lima The Philippines Manila Poland Warsaw Portugal Lisbon Qatar Doha Romania Bucharest Russia Moscow Rwanda Kigali St. Kitts and Nevis Basseterre (on St. Kitts) St. Lucia Castries St. Vincent and the Grenadines Kingstown Samoa Apia San Marino San Marino São Tomé and Príncipe São Tomé Saudi Arabia Riyadh Senegal Dakar Serbia and Montenegro Belgrade Seychelles Victoria Sierra Leone Freetown Singapore Singapore Slovakia Bratislava Slovenia Ljubljana Solomon Islands Honiara (on Guadalcanal) Somalia Mogadishu South Africa Pretoria; Legislative capital and largest city: Cape Town; Judicial capital: Bloemfontein . No decision has been made to relocate the seat of government. South Africa is demarcated into nine provinces consisting of the Gauteng Northern Province Mpumalanga North West KwaZulu/Natal Eastern Cape Western Cape Northern Cape and Free State. Each province has its own capital Spain Madrid Sri Lanka Colombo; Legislative and Judicial capital: Sri Jayawardenepura Kotte Sudan Khartoum Suriname Paramaribo Swaziland Mbabane Sweden Stockholm Switzerland Bern Syria Damascus Taiwan Taipei Tajikistan Dushanbe Tanzania Dar es Salaam ; Official capital: Dodoma Thailand Bangkok Togo Lomé Tonga Nuku'alofa Trinidad and Tobago Port-of-Spain Tunisia Tunis Turkey Ankara Turkmenistan Ashgabat Tuvalu Funafuti Uganda Kampala Ukraine Kyiv (Kiev) United Arab Emirates Abu Dhabi United Kingdom London United States Washington DC Uruguay Montevideo Uzbekistan Tashkent Vanuatu Port Vila Venezuela Caracas Vietnam Hanoi Western Sahara (proposed state) El Aaiun Yemen Sanaá Zambia Lusaka Zimbabwe Harare

Facilities

Services              

Location       

Health check and health consultation

Power health talks and seminars

Beauty and treatment sessions

Relaxation and sport massages

Weekly family bonding activities

Montaine outdoor activities

Fitness, self defence & leisure classes available

Fully equipped gym sets, steam, sauna, Jacuzzi

Personal trainers available.

Health drinks available.

At

Relaxation / Swedish Massage Remedial / Deep Tissue Massage Physiotherapy, Sport / Work-Related Injuries Stress / Anxiety Management Acupuncture, Shiatsu Aromatherapy / Essential Oils Reflexology Slimming and Weight loss Beauty and treatment sessions Ions Detox, Ozone Spa More....... Corporate Massage Mobile/home visit Hotels Montaine Center Massage Courses Montaine outdoor activities www.montaine.com.au

PLEASE CALL TO MAKE AN APPOINTMENT
 Tel :  (+603) 5636 6788 www.montaine.com.my
 No 16, 1st Floor, Jalan PJS 11/28, Bandar Sunway, 46150, Selangor, Malaysia
Tel : (612) 9264 4567 www.montaine.com.my 23/203 Castlereagh St, Sydney, NSW 2000, Australia